Division of Occupational Science and Occupational Therapy, School of Dentistry, University of Southern California, 1540 Alcazar Street, CHP 133, Los Angeles, CA 90089-9003, USA.
J Epidemiol Community Health. 2012 Sep;66(9):782-90. doi: 10.1136/jech.2009.099754. Epub 2011 Jun 2.
Older people are at risk for health decline and loss of independence. Lifestyle interventions offer potential for reducing such negative outcomes. The aim of this study was to determine the effectiveness and cost-effectiveness of a preventive lifestyle-based occupational therapy intervention, administered in a variety of community-based sites, in improving mental and physical well-being and cognitive functioning in ethnically diverse older people.
A randomised controlled trial was conducted comparing an occupational therapy intervention and a no-treatment control condition over a 6-month experimental phase. Participants included 460 men and women aged 60-95 years (mean age 74.9 ± 7.7 years; 53% <$12000 annual income) recruited from 21 sites in the greater Los Angeles metropolitan area.
Intervention participants, relative to untreated controls, showed more favourable change scores on indices of bodily pain, vitality, social functioning, mental health, composite mental functioning, life satisfaction and depressive symptomatology (ps<0.05). The intervention group had a significantly greater increment in quality-adjusted life years (p<0.02), which was achieved cost-effectively (US $41218/UK £24868 per unit). No intervention effect was found for cognitive functioning outcome measures.
A lifestyle-oriented occupational therapy intervention has beneficial effects for ethnically diverse older people recruited from a wide array of community settings. Because the intervention is cost-effective and is applicable on a wide-scale basis, it has the potential to help reduce health decline and promote well-being in older people. Trial Registration clinicaltrials.gov identifier: NCT0078634.
老年人面临健康状况恶化和丧失独立性的风险。生活方式干预为减少这些负面后果提供了潜力。本研究旨在确定一种基于预防生活方式的职业治疗干预措施在改善不同族裔老年人的身心健康和认知功能方面的有效性和成本效益，该干预措施在各种社区环境中实施。
一项随机对照试验比较了职业治疗干预和无治疗对照组在 6 个月的实验阶段的效果。参与者包括来自大洛杉矶大都市区 21 个地点的 460 名 60-95 岁的男性和女性（平均年龄 74.9 ± 7.7 岁；53%<12000 美元/年）。
与未治疗的对照组相比，干预组在身体疼痛、活力、社会功能、心理健康、综合心理功能、生活满意度和抑郁症状等指标上的变化评分更有利（p<0.05）。干预组的质量调整生命年显著增加（p<0.02），具有成本效益（每单位 41218 美元/24868 英镑）。干预组对认知功能的测量结果没有影响。
从广泛的社区环境中招募的不同族裔的老年人，采用生活方式导向的职业治疗干预措施具有有益的效果。由于干预措施具有成本效益，并且可以广泛应用，因此有可能帮助减少老年人的健康衰退，促进他们的幸福感。临床试验注册标识：NCT0078634。
